Influence of painful chronic neuropathy on neurogenic inflammation

The effect of topical application of capsaicin cream on neurogenic inflammation was investigated in a neuropathic pain model in rat. The neuropathic state was induced by loose ligation of the sciatic nerve with a chromic gut suture. A marked thermal hyperalgesia was observed in response to heat stimulation applied to the operated side from 3 days through 2 weeks, followed by a gradual return to the control level 35 days after surgery. In sham-operated animals, topical application of capsaicin cream to both sides of the hind paw, the instep and sole, as well as antidromic stimulation of the sciatic nerve led to a significant increase in the amounts of Evans blue and substance P (SP) released into the perfusates. This stimulus-induced extravasation was significantly suppressed by pretreatment with RP67580, an NK1 antagonist. On day 7 after ligation. capsaicin- and antidromic stimulation-induced extravasation were significantly reduced. At this time, both amount of SP released immediately after application of capsaicin and during antidromic stimulation were almost similar to that in sham-operated rats, whereas the basal amount of SP release significantly increased in ligated animals. In particular a major release of SP was detected immediately after the start of the perfusion compared with that in sham-operated rats. Plasma extravasation evoked by SP (10(-4) M) applied to the subcutaneous perfusate was significantly less in ligated than in sham-operated rats. These results suggest that nerve injury with chronic pain may produce increase in basal SP release into the peripheral tissues, and then such enhanced SP release cause reduction of SP-induced extravasation. (C) 2001 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.